O-M Debate: A Reflection and Follow-up
Thank you all so much for sharing your comments and research in our oral motor debate! As Lisa, CCC-SLP from VT stated, I "certainly stirred the pot" with last week's post. I did want to get us talking, but I didn't mean to create such a firestorm! This debate reminded me that I am part of a very devoted and passionate profession of women and men who believe in and stand by the work they do everyday which is definitely something to be proud of.
Reviewing all the comments offered and taking the time to critique my own contributions as well, here are my concluding thoughts:
Lisa went on to say that, "It (O-M therapy) is really an all-encompassing term that we should use carefully and specifically, making sure we use techniques that make sense in terms of our goals and our patients' needs". I agree with her and in addition, I believe that when we engage in a debate such as this, we need to clearly define the nature of the individual child's delay/disorder we are trying to treat, which helps to determine HOW we will treat it.
One of the readers, Sherril, CCC-SLP from NJ, offered a comment describing well the type of very young babies and toddlers I see in my current work position. She used the term "orally defensive". In my experience, many of these children also seem to present with global sensory-based issues that appear to be hindering a variety of milestones including their speech development and most likely their eating habits as well. Many times these children appear to be on the autism spectrum; however that may also not be the case and because they are so young that diagnosis has not come yet. With these children, their whole body is involved in the delay. These children often require a team of therapists to remediate their issues — OT, PT, Education and Speech in order to help them move along developmentally. Children who present in this way are very different from a kiddo with a speech delay, cleft palate, apraxia, etc., who may benefit from direct phonemic cuing, speech stimulation, etc. and who may only require the intervention of a speech therapist. All of these children present with a speech delay/disorder; however the cause of the problem is most likely very different.
In retrospect, I feel that I should have better defined the population I was addressing in my Oral-Motor Debate post.
In all the work that I do with children ages 0-3, when I use oral-motor methods to help stimulate oral movement, awareness, imitation, etc., it is simply one method and it does not stop there. The OM techniques I use are always accompanied by phonemic cuing and direct speech stimulation as well as pictures and sign language depending on the child's needs. The reason why I choose to incorporate the oral-motor piece is because the child is NOT responding to traditional speech therapy. Whenever oral-motor techniques are incorporated with a child who is "orally defensive" and also not using their mouth to communicate, I have seen positive results.
One final thought — I have learned firsthand as a student and recently as an adjunct professor and supervisor that what is found in our university classrooms, textbooks and research papers is absolutely vital and lays the foundation for our life's work. Just as important, however is hands-on experience in the field. To study and read about something is one thing, to live it everyday, problem-solve it by incorporating various techniques and put your skills to use in creative ways that work for individual children and families is quite different. When debating issues, such as oral-motor therapy, it is important that both be respected and heard.
Thank you again for reading and for your contributions to this blog!!